Very pricey health care benefits for city employees

If you have a mailbox or a TV, you’ve probably heard about Proposition B on Tuesday’s ballot and how it would force single mothers working for the city to pay $5,600 extra a year for their family’s health care. There’s an interesting backstory behind that figure.

That’ll be the cost for those with one dependant on the City Plan, dubbed by Prop. B sponsor Jeff Adachi “the Rolls Royce” of the three options for city employees because it costs a total of $36,000 per family that uses it. Prop. B would lower the city’s contribution toward that figure.

The City Plan – which is mandated under city charter – covers about 1,000 of the city’s 26,000 current employees. Few people pick it because it’s way more expensive than Kaiser or Blue Shield, especially if kids are in the picture. Just 88 of the roughly 8,500 employees with two or more dependants select the City Plan because they’ve currently got to pay $1,410.22 each month for it.

It’s not because the City Plan covers more types of medical care. The three plans offer pretty much the same services including covering a large portion of transgendered surgery (as required by a 2001 Board of Supervisors law), 50 percent of artificial insemination and in vitro fertilization, and drug rehab. The only difference we spotted was that Kaiser doesn’t cover acupuncture, and the others do.

Rather, people on the City Plan have a very broad selection of doctors and often choose it if their job – like working for the Public Utilities Commission near Hetch Hetchy – has them living in remote locations. Many retirees pick it if they’ve moved to the far reaches of California or out of state, and people with unusual medical conditions select it for the wide choice of specialists.

Catherine Dodd, director of the city’s Health Service System, said that makes for an older, sicker population on the plan which spikes the cost. She said that’ll get even worse if Prop. B passes because more young people and families will shift to the less expensive plans.

“Trust me, it’s something I’m looking at constantly – how are we going to figure this out?” Dodd said.